Povzročitelji in mikrobiološka diagnostika okužb pri nevtropeničnem bolniku = Etiologic agents and microbiological diagnosis of infections in patients with neutropenia
Patients with chemotherapy-induced neutropenia commonly suffer of infection. The risk of infection is dependent on the depth of neutropenia, the rate of decline in neutrophil count and duration of ...neutropenia. Microorganisms causing infection during neutropenia are inter?vined with microorganisms that cause infection because of a primary immune defect. Bacterial and fungal infections occur most frequently while viral and parasitary infections are rarely seen in neutropenic patients. Before the introduction of prophylaxis with quinolones and imidazoles. enterobacteria (Es-cherichia coli, Klebsiella pneumoniae, Enterobacter sp.), Pseudomonas aeruginosa and Staphylococcus aureus caused the most infections. Candida albicans and Aspergillus sp. were the most frequent fungal pathogens. After introduction of prophylaxis, which removes most of the opportunists infections, are less common and delayed. The most important etiologic agents became Staphylococcus epidermidis, Enterococcus sp., S. aureus, Streptococcus viridans and Candida sp. Hospital infections are usually caused by antibiotic resistant P. aeruginosa and other pseudomonads, Acinetobacter sp., enterobacteria, Enterococcus sp., S. aureus and Aspergillus sp. They are prevented with protective isolation of neutropenic patients and detected with surveillance cultures. Because colonization of neutropenic patients leads to infection very quickly, the prompt identification of causative agents and their antibiotic susceptibility with standard and new microbiological methods are extremely important.
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